The HSE and reorganisation


Sir, – I recall a now-retired manager of the local health service observing that each time there was a restructuring of the national health service, more layers of management were created.

When the HSE was brought into being, there was a promise of rationalisation without redundancies;only the public service could be capable of such impossible dreams. At that time, the local managers were recruited from within the health services to what were supposed to be management jobs for a five-year period.

Once appointed, these same managers renegotiated so that the jobs would be theirs for their working lives.

At present, we see how the nurses’ strike has led to an overspend on health but very few voices are raised against the decision to strike and hold the country to ransom.

Maybe we need to bring back the IMF. – Yours, etc,



Co Tipperary.

Sir, – During management training, Dr Chris Luke (Letters, July 6th) learned the perils of reorganisation from the writings of the Roman satirist, Gaius Petronius Arbiter: “creating the illusion of progress, while producing confusion, inefficiency, and demoralisation”.

He warns the HSE not to follow the same perilous path.

The passages Dr Luke quotes are entertaining but were concocted by Robert C Townsend for his tongue-in-cheek 1970 business book Up the Organisation. However, Townsend also suggests a positive alternative to reorganisation which he calls decluttering: “personnel departments, legal departments, advertising departments, and purchasing departments must be eliminated overnight”. A route the HSE would find also had its difficulties. – Yours, etc,


Dublin 4.

Sir, – So the HSE is to be broken up into six areas, each one administratively independent of the others. Like most people, I welcome the move, but I have a fear that there will be six new chief executives, each with his or her deputy chief executives, assistant chief executives, service managers, HR managers, as well as the current overall HSE chief executive and his entourage, and then all of them overseen by the secretariat of the Department of Health. Will there be any money left to pay the doctors and nurses? – Yours, etc,



Co Waterford.